Organization
INEMESIT EPHRAM UDOR MD. P.A.
Active
Other names
The Valley Neighborhood Pediatric Network
Organization subpart
No
Provider details
NPI number
Authorized official
INEMESIT E UDOR MD. P.A. (OWNER)
(956) 631-7312
Entity
Organization
Contact information
Practice address
2517 W. TRENTON RD., BLDG A STE 4, EDINBURG, TX 78539-5070
(956) 631-7312
(956) 631-7307
Mailing address
2517 W TRENTON RD., BIDG A STE 4, EDINBURG, TX 78539-5070
(956) 631-7312
(956) 631-7307
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K6377
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0092HG
BC&BS OF TEXAS
TX
05
—
116400604
—
TX
01
—
120285
SUPERIOR HEALTH PLAN
TX
05
—
145956201
—
TX
01
—
145956202
EPSOT
—
05
—
145956202
—
TX
01
—
K6377
TEXAS LIC
—
Enumeration date
03/30/2007
Last updated
11/24/2008
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